Harris Mark J, Kamara Thaim B, Hanciles Eva, Newberry Cynthia, Junkins Scott R, Pace Nathan L
Department of Anesthesiology (Rm 3C444), University of Utah Medical Center Salt Lake City, USA.
Department of Surgery, Connaught Hospital Freetown, Sierra Leone.
Afr Health Sci. 2015 Sep;15(3):1028-33. doi: 10.4314/ahs.v15i3.43.
To determine the unmet anaesthesia need in a low resource region.
Surgery and anæsthesia services in low- and middle-income countries (LMICs) are under-equipped, under-staffed, and unable to meet current surgical need. There is little objective measure as to the true extent and nature of unmet need. Without such an understanding it is impossible to formulate solutions. Therefore, we re-examined Surgeons OverSeas (SOSAS) unmet surgical need data to extrapolate unmet anaesthesia need.
For the untreated surgical conditions identified by SOSAS, we assigned anaesthetic technique required to carry out the procedure. The chosen anaesthetic was based on common practice in the region. Procedures were categorized into minimal anaesthesia, spinal anæsthesia, regional anaesthesia, ketamine/monitored anaesthesia care (MAC), and general endotracheal anæsthesia (GETA).
Ninety-two per cent (687 of 745) of untreated surgical conditions in Sierra Leone would require some form of anaesthesia. Seventeen per cent (125 of 745) would require MAC, 22% (167 of 745) would require spinal anaesthesia, and 53% (395 of 745) would require GETA.
Analyses such as this can provide guidance as to the rational and efficient production and distribution of personnel, drugs and equipment.
确定资源匮乏地区未满足的麻醉需求。
低收入和中等收入国家（LMICs）的外科手术和麻醉服务设备不足、人员配备不足，无法满足当前的手术需求。对于未满足需求的真实程度和性质，几乎没有客观的衡量标准。没有这样的了解，就无法制定解决方案。因此，我们重新审视了海外外科医生组织（SOSAS）未满足的手术需求数据，以推断未满足的麻醉需求。
对于SOSAS确定的未治疗的外科疾病，我们确定了实施该手术所需的麻醉技术。所选麻醉方法基于该地区的常见做法。手术分为最小麻醉、脊髓麻醉、区域麻醉、氯胺酮/监护麻醉（MAC）和全身气管内麻醉（GETA）。
在塞拉利昂，92%（745例中的687例）未治疗的外科疾病需要某种形式的麻醉。17%（745例中的125例）需要MAC，22%（745例中的167例）需要脊髓麻醉，53%（745例中的395例）需要GETA。
这样的分析可以为人员、药品和设备的合理有效生产与分配提供指导。
